Recently I was offered a part-time job helping a friend’s mother regain her speech following a stroke. I really, really like this woman and her mother and I am actually looking forward to helping them both get through this. Yesterday I tagged along to a hospital appointment with the speech therapist and I was struck by my friend’s energy and good humor as she guided her mother through her exercises. She has been taking her mother to appointments in the evenings and doing this alone for months after working long and physically and mentally exhausting days and seeing her teaching her elderly mother how to speak again nearly broke my heart.
My friend’s mother was a teacher in her previous life and apparently they used to play word-association games in the car during road trips, the kind of “games” that seem to be the playground of the generationally literate, the kind of wordplay I was never able to do or even care about to save my own life. I can tell that her mother is still very much “there” and that she just has trouble grasping and uttering the correct words (she asked me how to spell my name and after that she did not forget or stumble with it again). Apparently, the mother was initially extremely frustrated at her speech limitations and fought against the stress and exertion (and compounding failures) of her speech exercises but has since calmed down a bit; she does her homework and participates in her exercises without much complaint. My friend told me they try to have fun with it and they end up laughing a lot. I’m glad she told me that explicitly — that they were deliberately trying to make it fun — because that is not a tack I would’ve known to take as I find the whole thing very unsettling in the vein of Dworkin and her comments on female old age and how that plays out under late stage capitalism and patriarchy. I’m glad they had me go once as an observer to see how it’s all supposed to work. Of course, after observing for a bit I had a question.
In my isolated, sick and medicated state, while I can still write and watch videos (and read in moderation) I actually think my own speech and memory skills have begun to fail. My friend and the speech therapist were running my friend’s mother through word association and “priming” exercises which went something like this: “Watermelon, fire truck, camping, blood, starfish. Which of these things are red?” I should mention that she also lost a lot of her eyesight in the stroke so she can’t look at the list, or refer back to it, she just has to remember the list as it’s being read aloud and then only afterwards is given the “category” she is supposed to be sorting them into (e.g. things that are red). Considering her circumstances she does remarkably well at remembering the list when I myself was having a difficult time remembering the items and then sorting them after the fact.
The way it played out in practice made it completely clear to me that if she can’t remember the list, they are going to think her troubled response is a speech-related problem and not a memory-related one. And although I had a feeling this outcome was unintentional, I didn’t know for sure or whether it mattered because the policy/intent behind speech therapy in her case had not been explained to me. For an elderly woman who has just had a stroke, this seemed needlessly cumbersome, not to mention cruel and unfair, assuming the exercises were not intended to include the obvious memory challenge that was baked-into doing it that way.
So of course I have to ask the question. Are you trying to test her memory too, or just her speech? And I go on to describe the COMPLETELY OBVIOUS memory challenge that’s built into these exercises as offered — reading the list of items aloud before the category into which she is supposed to be sorting them. And although they had been running her through these exercises this way for months, neither my friend nor the speech therapist had ever considered that before. The therapist said that it was not in fact intended as a memory challenge, and based on what I said he decided to change the format of the exercises to this inverted format: “Which of these things are red: watermelon, fire truck, camping, blood, starfish?” and of course based on her answers, which were quicker and more accurate with less struggle her “speech” miraculously and instantly improved enough to be noticeable. Jesus fucking Christ. She’s still in a bad way of course, but I could tell the new format improved her responses and surely will help alleviate some frustration for this poor woman who is struggling not just with speech but with memory issues due to both her stroke-related disability and age.
I don’t even know what to say about that except that I hope I can help this woman get her speech back and that I can help relieve the burden on my friend who is attempting to navigate an insanely incompetent medical system on behalf of her disabled, elderly mother, alone. And I have no idea whether I will even mentally or physically be able to help care for this woman like she needs to be cared for or even whether the speech therapist will clock me as having some impairments of my own; if he does I hope he will keep it to himself.
Based on what has already transpired I do feel as if I have something to offer in this situation and I hope it will work out well for everyone involved. I do not feel any more secure about my own illness or aging process, knowing that even speech therapists are completely incompetent to do their fucking jobs and worse yet, they have no idea how incompetent they truly are. The only positive thing I can think to mention was that the therapist was very willing to change the program when an intelligent constructive criticism was offered, and that he was able to take questions and implied and actual criticism from a female to boot. Honestly sometimes I think people get tired of dealing with stupid people and when someone who is clearly not stupid blows in it’s like a breath of fresh air to them. No one in that room was a moron, not a one of us, and it ended well. So far, so good, although I truly hope I never have to rely on this system for ANYTHING. If I ever have a stroke I hope it kills me. Comments and advice welcome.